After the Acute Vestibular Syndrome: What Recovers, What Persists, and What Conventional Tests May Miss

Cochlear implants (CI) are neuroprosthetic devices which restore hearing in severe-to-profound deafness through direct electrical stimulation of the auditory nerve. Current cis use an external audio processor that is worn behind the ear, which houses the microphone, power source, and signal processing hardware. For users, this external device can be a source of both inconvenience and limitations. A long-term goal in the field has been to develop a new generation of implants in which all components are contained within a single subdermal implant.

we present our surgical considerations and experience for the TICI, which are based on the experience with all generations of MED-EL implants, from the combi 40 in 1994 until the synchrony 2 from today. Key elements that also apply to the surgical technique of a “normal” CI are highlighted.

clinical results from the one year follow up feasibility study with the totally implantable cochlear implant (TICI) and data for 5 years follow up until october 2025 from the munich patients are shown. Clinical testing showed that the TICI provides high levels of hearing performance early after first fitting, equivalent to that of a conventional CI (73% monosyllabic words in quiet, -2.2db SNR in noise [OLSA]). At the one year interval we found no difference between invisible mode and the classical CI mode in quiet as well as in noise. The results remain stable over more than 5 years

the development of the TICI is a step into a new technological era and advances the field of audiology and hearing implants.

Paediatric Auditory Brainstem Implantation: Patient Selection, Surgical Challenges and Management of Complications

Paediatric auditory brainstem implantation (ABI) represents one of the most technically demanding and ethically complex interventions in contemporary otology and neurotology. While ABI has become an established option for children with profound deafness who are not candidates for cochlear implantation, its use—particularly in non-tumour paediatric indications—continues to evolve, with significant international variation in patient selection, surgical technique, outcome reporting and complication management.

This panel discussion aims to provide a comprehensive, experience-driven overview of current paediatric ABI practice, bringing together international experts to critically examine areas of consensus and controversy. The session will focus on three inter-related domains: patient selection, surgical and peri-operative challenges, and the prevention and management of complications.

The first part of the discussion will address patient selection and candidacy assessment. Key topics will include radiological and anatomical criteria, neurodevelopmental considerations, timing of implantation, counselling of families, and the role of multidisciplinary decision-making. Particular attention will be given to borderline cases, expanding indications beyond tumour-related deafness, and balancing potential auditory benefit against surgical risk in children with complex additional needs.

The second component will explore surgical challenges unique to paediatric ABI. Panellists will discuss approaches to the lateral recess of the fourth ventricle, intra-operative neurophysiological monitoring, electrode placement and fixation, and strategies to minimise neurological morbidity. Differences in surgical philosophy, learning curves, and institutional experience will be highlighted, with an emphasis on practical lessons learned from high-volume international centres.

The final section will focus on complications and outcome optimisation. Topics will include cerebrospinal fluid leak, lower cranial nerve dysfunction, device migration or malfunction, non-auditory stimulation, and long-term rehabilitation challenges. The panel will also address how complications are reported, communicated to families, and incorporated into governance, audit and international registries, as well as the need for standardised outcome measures.

The session will be highly interactive, incorporating case-based discussion and audience participation. It is intended for otologists, neurotologists, paediatric ENT surgeons, audiologists and senior trainees, and aims to stimulate informed debate, share best practice, and identify priorities for future collaboration and consensus development in paediatric auditory brainstem implantation.

Beyond vHIT: Functional VOR Assessment with fHIT